TY - JOUR
KW - Analgesics, Opioid/administration & dosage/adverse effects/therapeutic use
KW - Chronic Disease
KW - Dose-Response Relationship, Drug
KW - Drug Monitoring/methods
KW - Female
KW - Humans
KW - Male
KW - Opioid-Related Disorders/complications/etiology/physiopathology
KW - Pain Measurement
KW - Pain/drug therapy
KW - Pregnancy
KW - Treatment Outcome
AU - R. Chou
AU - G. J. Fanciullo
AU - P. G. Fine
AU - J. A. Adler
AU - J. C. Ballantyne
AU - P. Davies
AU - M. I. Donovan
AU - D. A. Fishbain
AU - K. M. Foley
AU - J. Fudin
AU - A. M. Gilson
AU - A. Kelter
AU - A. Mauskop
AU - P. G. O'Connor
AU - S. D. Passik
AU - G. W. Pasternak
AU - R. K. Portenoy
AU - B. A. Rich
AU - R. G. Roberts
AU - K. H. Todd
AU - C. Miaskowski
AU - American Pain Society-American Academy of Pain Medicine Opioids Guidelines Panel
A1 - 
AB - UNLABELLED: Use of chronic opioid therapy for chronic noncancer pain has increased substantially. The American Pain Society and the American Academy of Pain Medicine commissioned a systematic review of the evidence on chronic opioid therapy for chronic noncancer pain and convened a multidisciplinary expert panel to review the evidence and formulate recommendations. Although evidence is limited, the expert panel concluded that chronic opioid therapy can be an effective therapy for carefully selected and monitored patients with chronic noncancer pain. However, opioids are also associated with potentially serious harms, including opioid-related adverse effects and outcomes related to the abuse potential of opioids. The recommendations presented in this document provide guidance on patient selection and risk stratification; informed consent and opioid management plans; initiation and titration of chronic opioid therapy; use of methadone; monitoring of patients on chronic opioid therapy; dose escalations, high-dose opioid therapy, opioid rotation, and indications for discontinuation of therapy; prevention and management of opioid-related adverse effects; driving and work safety; identifying a medical home and when to obtain consultation; management of breakthrough pain; chronic opioid therapy in pregnancy; and opioid-related policies. PERSPECTIVE: Safe and effective chronic opioid therapy for chronic noncancer pain requires clinical skills and knowledge in both the principles of opioid prescribing and on the assessment and management of risks associated with opioid abuse, addiction, and diversion. Although evidence is limited in many areas related to use of opioids for chronic noncancer pain, this guideline provides recommendations developed by a multidisciplinary expert panel after a systematic review of the evidence.
BT - The journal of pain : official journal of the American Pain Society
C5 - Opioids & Substance Use
CP - 2
CY - United States
DO - 10.1016/j.jpain.2008.10.008
IS - 2
JF - The journal of pain : official journal of the American Pain Society
N2 - UNLABELLED: Use of chronic opioid therapy for chronic noncancer pain has increased substantially. The American Pain Society and the American Academy of Pain Medicine commissioned a systematic review of the evidence on chronic opioid therapy for chronic noncancer pain and convened a multidisciplinary expert panel to review the evidence and formulate recommendations. Although evidence is limited, the expert panel concluded that chronic opioid therapy can be an effective therapy for carefully selected and monitored patients with chronic noncancer pain. However, opioids are also associated with potentially serious harms, including opioid-related adverse effects and outcomes related to the abuse potential of opioids. The recommendations presented in this document provide guidance on patient selection and risk stratification; informed consent and opioid management plans; initiation and titration of chronic opioid therapy; use of methadone; monitoring of patients on chronic opioid therapy; dose escalations, high-dose opioid therapy, opioid rotation, and indications for discontinuation of therapy; prevention and management of opioid-related adverse effects; driving and work safety; identifying a medical home and when to obtain consultation; management of breakthrough pain; chronic opioid therapy in pregnancy; and opioid-related policies. PERSPECTIVE: Safe and effective chronic opioid therapy for chronic noncancer pain requires clinical skills and knowledge in both the principles of opioid prescribing and on the assessment and management of risks associated with opioid abuse, addiction, and diversion. Although evidence is limited in many areas related to use of opioids for chronic noncancer pain, this guideline provides recommendations developed by a multidisciplinary expert panel after a systematic review of the evidence.
PP - United States
PY - 2009
SN - 1528-8447; 1526-5900
SP - 113
EP - 130
EP - 
T1 - Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain
T2 - The journal of pain : official journal of the American Pain Society
TI - Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain
U1 - Opioids & Substance Use
U2 - 19187889
U3 - 10.1016/j.jpain.2008.10.008
VL - 10
VO - 1528-8447; 1526-5900
Y1 - 2009
ER -